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SE Loudon, BL Verhoef, J Polling, HJ Simonsz; Amblyopic Children With Low Compliance Measured Electronically Have Insufficient Acuity Increase . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4696.
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Purpose: Preparing for a prospective randomised study on compliance in patching for amblyopia, we first assessed in a pilot study the relation between compliance and acuity increase. Methods: In 14 new amblyopic children (mean age 4.3 ± 1.9 years) compliance was measured electronically during 1 week, 6 months after start of patching, with an Occlusion Dose Monitor (ODM) which was developed in the public domain in 1996-1997. They had anisometropia (n=5), strabismus (n=4) or both (n=5). The ODM was distributed through house visits. Compliance was expressed as percentage of the registered time compared to the prescribed occlusion time. Satisfactory acuity increase was defined as: (a) acuity amblyopic eye divided by acuity good eye ≷ 0.75, (b) acuity exceeding 0.5 E-chart or (c) 3 lines LogMAR acuity increase. Results: Measured compliance (detailed on right-hand side of Fig.) averaged 80% in 8 children who had satisfactory acuity increase (open symbols), and 34% in 6 children who had not (closed symbols). Children with low compliance had statistically less acuity increase (p=0.036). One child's acuity increased from 0.5 to 1.0 despite 5% compliance; he had been prescribed glasses simultaneously with patching. When left out of analysis, significance increased to p<0.01. Conclusion: We confirmed by electronic measurement that compliance is low in children with insufficient acuity increase. However, several confounding factors were identified, like glasses prescribed together with patching and variation in prescribed hours of patching among orthoptists. Preliminary results from the prospective randomised study show that it is possible to enhance compliance and that risk factors for non-compliance are different from what is generally believed. View OriginalDownload SlideView OriginalDownload Slide
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